手持式红外测温仪评估干眼患者眼表温度的研究

Application of handheld infrared thermometer in the evaluation of ocular surface temperature in dry eye

目的 比较正常人群与干眼患者的眼表温度(OST),评估OST用于干眼筛查的可行性。方法本研究纳入2021年12月~2022年1月在复旦大学附属眼耳鼻喉科医院干眼门诊就诊的84例(84眼)18~85岁干眼患者和20例(20眼)年龄性别匹配的正常志愿者,采用手持式红外测温仪检测受检者的体温与OST,比较不同组受检者OST的差异并且分析其与荧光染色泪膜破裂时间(FBUT)、泪液分泌试验(SⅠt)、睑板腺缺失评分及角膜荧光染色(FL)评分的关系。结果 干眼组OST值为(36.48±0.18)℃,显著低于正常组的(36.67±0.26)℃,P<0.001。干眼程度越重,OST值越低(P=0.003)。相关性分析发现,干眼患者OST值与体温、FBUT成正相关(体温:r=0.57,P<0.001;FBUT:r=0.36, P=0.001),与睑板腺缺失评分成负相关(r=-0.24,P=0.028)。将OST值36.53℃用于中重度干眼筛查,其特异度和灵敏度为78%和75%。结论 干眼患者的OST值较低,与泪膜稳定性差关系密切。使用手持式红外测温仪检测OST,具有廉价、方便和快捷的优势,有助于大范围人群的干眼筛查。

Objective To compare the ocular surface temperature(OST)in normal eyes and dry eye patients,and to evaluate its diagnostic potential in the screening of dry eye.Methods Eighty-four dry eye patients(aged 18-85 years)and 20 age-and sex-matched normal volunteers were enrolled in the study from December 2021 to January 2022.The handheld infrared thermometer was used to detect the OST and body temperature.The difference of OST between normal eyes and dry eyes was compared,and its correlations with body temperature,age,fluorescein tear film break-up time(FBUT),SchirmerⅠtest(SⅠt),meibomian gland dropout and f'luorescein staining(FL)score were analyzed.Results The OST value in dry eye patients(84 eyes,36.48±0.18℃)was significantly lower than that in normal persons(20 eyes,36.67±0.26℃,P<0.001)with more lower OST value in more severe dry eye patients(P=0.003).Correlation analysis showed that OST was positivety correlated with body temperature and FBUT(body temperature:r=0.57,P<0.001;FBUT:r=0.36,P=0.001),and had negatively correlated with the score of meibomian gland dropout(r=-0.24,P=0.028).The OST value(36.53℃)showed a specificity 78%and sensitivity 75%for screening the moderate and severe dry eye.Conclusions The OST significantly decreased in dry eye patients,especially in those with an unstable tear film.The use of handheld infrared thermometer to detect OST is cheap,convenient and quick,which is helpful for dry eye screening in a large population.